Kulak burun boğaz cerrahisi geçiren pediatrik hastalarda intraoperatif uygulanan sıvı volümünün postoperatif kusmaya etkisi

Yıl 2019, Cilt: 9 Sayı: 1, 21 - 26, 27.03.2019

Sinan Yılmaz Dilek Yılmaz

https://doi.org/10.16899/gopctd.531288

Öz

Giriş ve Amaç:Çocuklarda postoperatif bulantı ve kusmayı önlemek için, uluslararası kılavuzlarda intravenöz sıvı tedavisi önerilmektedir. Fakat, sıvı tedavisinin uygun miktarı henüz belli değildir. Bu gözlemsel çalışmanın amacı, adenoidektomi, tonsillektomi ve adenotonsillektomi yapılan çocuklarda intraoperatif intravenöz sıvı uygulamasının postoperatif kusma üzerine etkisini değerlendirmektir.

Yöntem
ve Gereçler: Genel
anestezi altında elektif adenoidektomi, tonsillektomi ve adenotonsillektomi yapılacak,
2-10 yaş arası 160 çocuk, intraoperatif infüzyon uygulamasına göre, düşük volümlü
(grup 1 = 10 ml/kg/s) veya yüksek volümlü (grup 2 = 20 ml/kg/s)% 0.9 NaCl solüsyonu
olarak randomize edildi. Standart bir anestezi protokolü uygulandı. Tüm
hastaların kusma ve ağrı skorları değerlendirildi.

Bulgular: Anestezi sonrası bakım ünitesinde (PACU)
birinci ve 15. dakikadaki kusma sıklığı, kısıtlı sıvı alan grup 1 hastalarda grup
2 hastalardan anlamlı derecede yüksekti. Anestezi sonrası bakım ünitesinde
(PACU) 1. ve 15. dakikada çocuk hastanesi doğu ontario ağrı ölçeği (CHEOPS)
skorları, grup 2'de grup 1'den anlamlı yüksek bulundu (p = 0.021, p = 0.026).
Ancak, iki grup arasında CHEOPS skorlarıyla ilgili daha sonraki zamanlarda anlamlı
bir fark bulunmadı.

Sonuç: Sonuçlarımız, intraoperatif 20 ml/kg/saat % 0.9 NaCl solüsyonu
uygulamasının, adenoidektomi, tonsillektomi ve adenotonsillektomi uygulanan
çocuklarda, postoperatif birinci ve 15. dakikalarda hafif kusma şikayetini
azaltmada yararlı olabileceğini desteklemektedir.

Anahtar Kelimeler

postoperatif kusma, çocuklar, intravenöz sıvı

The effect of intraoperative fluid volume on postoperative vomiting in pediatric patients undergoing otorhinolaryngological surgery

Öz

Aim:Intravenous fluid therapy is recommended in international guidelines to prevent the postoperative nause and vomiting in children. But the proper amount of fluid therapy is not clear yet. The aim of this observational study is to evaluate the effect of intraoperative intravenous fluid administration on postoperative vomiting in children after adenoidectomy, tonsillectomy and adenotonsillectomy.

Material
and Methods: 160 children, aged between 2-10 years, undergoing elective
adenoidectomy, tonsillectomy and adenotonsillectomy under general anaesthesia were
randomized to administration of intraoperative infusions of low-volume (group
1=10 ml/kg/h) or high volume (group 2=20/ml/kg/h) 0.9 % NaCl solution. A
standardized anaesthesia protocol was performed. The vomiting and pain scores of
all patients were evaluated.

Results: The
frequency of vomiting in patients who received limited fluid in group 1 was
significantly higher than those in group 2 at first and 15^th minute
in post-anesthesia care unit (PACU). The Children’s Hospital East
Ontario Pain Scale (CHEOPS) scores at 1^st and 15^th
minutes of PACU were significantly higher in group 2 than in group 1 (p =
0.021, p = 0.026) However, no significant difference was found between the two
groups regarding CHEOPS scores at the further time-points.

Conclusion: Our results suggest that
intraoperative administration of 0.9% NaCl solution at a rate of 20 ml/kg/h can be useful in
reducing mild vomiting complaint in the postoperative first and 15^th
minutes in children undergoing adenoidectomy, tonsillectomy, and
adenotonsillectomy.

Anahtar Kelimeler

postoperative vomiting, children, intravenous fluid

Kaynakça

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